![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 35 to 59 of 59. Go back in thread:
Posted by undopaminergic on April 26, 2008, at 16:39:25
In reply to Re: 6 weeks on Nardil » Jedi, posted by 4WD on April 25, 2008, at 14:56:01
>
> But as I told my pdoc when I asked to be put on Nardil: I'm willing to put up with any side effect if the Nardil gives me my life back. And it has and I am willing to put up with the side effects. In fact, I had some lab work done last week and two of my liver enzymes have become slightly elevated from the Nardil. You know what? I don't care. If my liver enzymes are a little too high, well, that's just too bad. Nothing is going to take my life back away from me now that I have experienced what life can be like on Nardil.
>Elevated enzymes may not be significant, but if it were to result in serious and irreversible liver dysfunction, it would be a different matter. There are some supplements, such as SAMe (S-adenosylmethionine), methionine and N-acetylcysteine, that could potentially be useful in protecting the liver when taken along with Nardil (or acetaminophen/paracetamol and other drugs with hepatoxic potential).
Posted by 4WD on April 26, 2008, at 19:10:45
In reply to Re: 6 weeks on Nardil, posted by undopaminergic on April 26, 2008, at 16:39:25
>
> Elevated enzymes may not be significant, but if it were to result in serious and irreversible liver dysfunction, it would be a different matter. There are some supplements, such as SAMe (S-adenosylmethionine), methionine and N-acetylcysteine, that could potentially be useful in protecting the liver when taken along with Nardil (or acetaminophen/paracetamol and other drugs with hepatoxic potential).I hadn't heard about methionine being liver protective. Or maybe I did a long time ago when I used to abuse opiates and got a lot too much tylenol in my system. I think I'll try the milk thistle first. It somehow seems more benign than methionine or N-acetylcysteine. If the milk thistle doesn't work and my enzymes are still elevated when I go back for retesting, I will try the big guns. Or maybe I will buy some methionine now. Would it be a good idea to take milk thistle AND methionine? Remember that only two enzymes were elevated and one of those was only 1 point above normal and one was 15 above normal.
I believe that it may also just be my body adjusting to the Nardil and I believe that when I go back for retesting my enzymes will have returned to normal. I'm certainly not worried about one point above normal. But I believe that things will straighten themselves out (with God's help) and they will have returned to normal or at least to a level which is not an issue.
Marsha
Posted by Phillipa on April 26, 2008, at 19:45:15
In reply to Re: 6 weeks on Nardil, posted by 4WD on April 26, 2008, at 19:10:45
Marsh did you try med checker for safety? google it and add your meds. Love Phillipa
Posted by Questionmark on April 27, 2008, at 2:09:31
In reply to Re: 6 weeks on Nardil » 4WD, posted by Jedi on April 25, 2008, at 1:14:21
Jedi is right. You cannot lower Nardil to 1 pill a day after achieving remission (unless you never needed a normal Nardil dose in the first place) without suffering the consequences. That is pure bunk. It is a myth-- just like the idea that you can't eat raspberries or bananas or raisins or coffee or chocolate with Nardil. And yes, as Jedi very wisely points out, the PDR *IS* often wrong, as are MDs and psychiatrists (and boy do i mean often). I'm sorry, but if you are on the minimum effective Nardil dose to achieve remission, you cannot even lower the dose without eventually noticing it (might take a month, but not much longer). Just my opinion. But i strongly believe that.
Yeah, believe me, i used to be really excited by that idea/ those statements too. Then i realized how bs it was. (Can i say "bs"? If not i apologize).
Oh, and the whole mg per kg thing (i.e., mg Nardil per kg body weight)? Bunk. I used to think it was true too (they said it was!), but think about it! How freaking ridiculously over-simplistic and medically naive is that?! Sure, it doesn't matter who the person is or how severe their condition is, all that matters is that they 1 mg Nardil (or however many it was) per kg of body weight! Who are these morons who come up with this and how do they get MDs??!
Ok sorry i'll shut up now.
> Hi Marsha,
> I'm so glad that Nardil is helping you feel better. It is the only med that has ever worked for me. Everybody is different, but I've tried lowering my dosage of Nardil slowly several times. As soon as the MAO inhibition goes below a certain level for a period of time, my major depression returns. I keep trying because several of the side effects still bother me even after being on Nardil for most of eleven years. Luckily for me, when I raise my dosage back up to 75 or 90mg the depression remits faster than when I first started the medication. I believe this is because I still have some MAO inhibition built up in my system. The PDR is often wrong, same as PDOCs and MDs.
> Good luck and be well,
> Jedi
>
> ...
> > The older doctor who used to prescribe Nardil a lot told me something very interesting. In fact, he read it to me from the PDR. It said that once complete remission has been achieved on Nardil, the dosage should be lowered slowly by one pill a day over a period of time. It even said that you should go as low as one pill a day or even one every other day and the Nardil would still maintain it's efficacy. I don't think I'd go to one pill every other day but it's exciting to think that after I've achieved complete remission, I can go down to 30mg a day instead of 45. Maybe that will lessen the side effects. And then if I don't feel depression creeping back in, I'll try going to 15 mg a day.
> ...
Posted by undopaminergic on April 27, 2008, at 4:41:58
In reply to Re: 6 weeks on Nardil, posted by 4WD on April 26, 2008, at 19:10:45
>
> >
> > Elevated enzymes may not be significant, but if it were to result in serious and irreversible liver dysfunction, it would be a different matter. There are some supplements, such as SAMe (S-adenosylmethionine), methionine and N-acetylcysteine, that could potentially be useful in protecting the liver when taken along with Nardil (or acetaminophen/paracetamol and other drugs with hepatoxic potential).
>
> I hadn't heard about methionine being liver protective. Or maybe I did a long time ago when I used to abuse opiates and got a lot too much tylenol in my system. I think I'll try the milk thistle first. It somehow seems more benign than methionine or N-acetylcysteine. If the milk thistle doesn't work and my enzymes are still elevated when I go back for retesting, I will try the big guns. Or maybe I will buy some methionine now. Would it be a good idea to take milk thistle AND methionine?
>Statistically speaking, I think taking multiple supplements would increase the probability of including the "right" one that is most effective against Nardil toxicity. There seem to be no studies at all addressing this issue.
Posted by 4WD on April 27, 2008, at 8:21:15
In reply to Re: 6 weeks on Nardil » 4WD, posted by Phillipa on April 26, 2008, at 19:45:15
> Marsh did you try med checker for safety? google it and add your meds. Love Phillipa
Phillipa,
Safety of what? Drug interactions? Or the liver thing or what?
Marsha
Posted by 4WD on April 27, 2008, at 8:38:19
In reply to The lowering Nardil after remission myth (+others) » Jedi, posted by Questionmark on April 27, 2008, at 2:09:31
I don't plan on lowering Nardil anytime soon. I might go down from 45 to 30 to minimize side effects but believe me, if I start losing the effectiveness I'll go right back up.
OTOH, what could it hurt to try it? If I went down to 30 for a while and was maintaining remission, then I might be willing to try going down to 15 and just see if I could maintain remission on that dose. If I lose my remission, I can always go back up to 30 or 45 if necessary.
As to whether it's a myth or not, I need to have things proven to me. I have to try it for myself. And why not try taking the lowest dose possible - to minimize side effects and the liver enzyme problem?
I just don't know yet. I'll have to take it one day at a time and just see what happens. I'm still only at 7 and a half weeks and I'm pretty much in full remission at 45mg. Maybe at 12 weeks, I'll go down to 30mg and see what happens.
Marsha
Posted by 4WD on April 27, 2008, at 8:46:40
In reply to Re: 6 weeks on Nardil, posted by undopaminergic on April 27, 2008, at 4:41:58
>
> Statistically speaking, I think taking multiple supplements would increase the probability of including the "right" one that is most effective against Nardil toxicity. There seem to be no studies at all addressing this issue.Well, it's only about three weeks now till I am retested. If the milk thistle hasn't helped I'll switch to or add methionine. I just have so many pills to keep up with taking. I'd rather take the minimum of stuff that will do the job. There is also the possibility of lowering the Nardil to a little less than 45mg. My pdoc has already suggested that I cut my last pill of the day in half and reduce my dosage by 7.5mg/day to minimize the hypotension problem. I haven't done it yet because I don't want to risk losing my remission. He said that small a dosage reduction wouldn't make a difference he didn't think, though. So maybe I'll try that for a week or so and see what happens.
Marsha
Posted by Phillipa on April 27, 2008, at 18:26:02
In reply to Re: 6 weeks on Nardil » Phillipa, posted by 4WD on April 27, 2008, at 8:21:15
Marsha drug interrations think it may have herbs too not sure though. Love Phillipa
Posted by Questionmark on July 10, 2008, at 22:42:15
In reply to Re: The lowering Nardil after remission myth (+oth » Questionmark, posted by 4WD on April 27, 2008, at 8:38:19
Hey (sorry for super late response). No, definitely that sounds like a smart idea. Nothing is as convincing as-- or even means anything compared to-- personal experience. I hope it's working well for you.
> I don't plan on lowering Nardil anytime soon. I might go down from 45 to 30 to minimize side effects but believe me, if I start losing the effectiveness I'll go right back up.
>
> OTOH, what could it hurt to try it? If I went down to 30 for a while and was maintaining remission, then I might be willing to try going down to 15 and just see if I could maintain remission on that dose. If I lose my remission, I can always go back up to 30 or 45 if necessary.
>
> As to whether it's a myth or not, I need to have things proven to me. I have to try it for myself. And why not try taking the lowest dose possible - to minimize side effects and the liver enzyme problem?
>
> I just don't know yet. I'll have to take it one day at a time and just see what happens. I'm still only at 7 and a half weeks and I'm pretty much in full remission at 45mg. Maybe at 12 weeks, I'll go down to 30mg and see what happens.
>
> Marsha
Posted by 4WD on July 15, 2008, at 20:34:13
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Questionmark on July 10, 2008, at 22:42:15
Hi,
Well, I can't go down now. I am doing well at 45 and I'm not particularly worried about the liver enzyme thing. I am kind of in a bad way. I broke my back (compression fracture at T12) about 6 weeks ago and am having surgery Friday. I've been on narcotic pain meds since I originally went to the hospital about 6 weeks ago and it's going to be hard enough to come off of those after the surgery. That's assuming the surgery relieves the pain as it's supposed to . So guess I'll stay with 45mg for the time being and worry about the liver enzyme things later when I have a little less other stuff to worry about.
Marsha
> Hey (sorry for super late response). No, definitely that sounds like a smart idea. Nothing is as convincing as-- or even means anything compared to-- personal experience. I hope it's working well for you.
>
> > I don't plan on lowering Nardil anytime soon. I might go down from 45 to 30 to minimize side effects but believe me, if I start losing the effectiveness I'll go right back up.
> >
> > OTOH, what could it hurt to try it? If I went down to 30 for a while and was maintaining remission, then I might be willing to try going down to 15 and just see if I could maintain remission on that dose. If I lose my remission, I can always go back up to 30 or 45 if necessary.
> >
> > As to whether it's a myth or not, I need to have things proven to me. I have to try it for myself. And why not try taking the lowest dose possible - to minimize side effects and the liver enzyme problem?
> >
> > I just don't know yet. I'll have to take it one day at a time and just see what happens. I'm still only at 7 and a half weeks and I'm pretty much in full remission at 45mg. Maybe at 12 weeks, I'll go down to 30mg and see what happens.
> >
> > Marsha
Posted by Phillipa on July 15, 2008, at 20:54:31
In reply to Re: The lowering Nardil after remission myth (+oth » Questionmark, posted by 4WD on July 15, 2008, at 20:34:13
Marsha thank heavens you posted was worried about you . Now do you have to discontinue the nardil for surgery? Love Phillipa
Posted by 4WD on July 15, 2008, at 21:08:39
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Phillipa on July 15, 2008, at 20:54:31
> Marsha thank heavens you posted was worried about you . Now do you have to discontinue the nardil for surgery? Love Phillipa
I have sent you a couple of mails with more details but I am doing fairly okay. I don't have to discontinue the Nardil for surgery, just can't take any anti inflammatories. I will tell them again about being on Nardil but last time I was in the hospital none of the meds they gave me had any bad interaction with the Nardil so I guess it will be the same meds this time so probably no problems. If there is a problem, I will be in the right place to deal with it - the hospital.The doctors and nurses hardly seem to have heard of Nardil. I have to keep telling them it's an MAOI and causes low blood pressure spells and BP fluctuations. But I think things will work out fine. I'm just so relieved to have the surgery scheduled - I can't stand this pain any longer.
Love,
marsha
Posted by Questionmark on July 16, 2008, at 0:14:04
In reply to Re: The lowering Nardil after remission myth (+oth » Phillipa, posted by 4WD on July 15, 2008, at 21:08:39
Oh my goodness, i am so sorry to hear that. I hope everything is fine after the surgery.
And yeah, it's amazing how many people in the medical field haven't even heard of or don't know what Nardil or an MAOI is. Amazing and quite aggravating too.
But good luck to you. I wish you the best.
> > Marsha thank heavens you posted was worried about you . Now do you have to discontinue the nardil for surgery? Love Phillipa
>
>
> I have sent you a couple of mails with more details but I am doing fairly okay. I don't have to discontinue the Nardil for surgery, just can't take any anti inflammatories. I will tell them again about being on Nardil but last time I was in the hospital none of the meds they gave me had any bad interaction with the Nardil so I guess it will be the same meds this time so probably no problems. If there is a problem, I will be in the right place to deal with it - the hospital.
>
> The doctors and nurses hardly seem to have heard of Nardil. I have to keep telling them it's an MAOI and causes low blood pressure spells and BP fluctuations. But I think things will work out fine. I'm just so relieved to have the surgery scheduled - I can't stand this pain any longer.
>
> Love,
> marsha
>
Posted by Phillipa on July 16, 2008, at 19:30:15
In reply to Re: The lowering Nardil after remission myth (+oth » Phillipa, posted by 4WD on July 15, 2008, at 21:08:39
Marsha what can you take for fevers or a headache? Love Phillipa
Posted by 4WD on July 17, 2008, at 0:23:40
In reply to Re: The lowering Nardil after remission myth (+oth, posted by Questionmark on July 16, 2008, at 0:14:04
Thank you for the good thoughts. There are really two issues I have to deal with and I'd appreciate those good thoughts and prayers. First, of course is the surgery itself. (That it go well and relieve the pain. Supposedly this procedure has about a 90% success rate and my doctor said he has done a few hundred of them so I'm not too awfully nervous about it. I'll be actually glad to get there and get it done.)
Actually, the other issue worries me more. I've been on narcotic pain medication for over six weeks now and after the surgery, assuming all goes well, I'll be coming off pain meds. I am a former opiate abuser and I'll admit I have really enjoyed my pain meds. But I have built up such a tolerance to them (high tolerance to begin with because of the prior years of abuse)that it is going to be really hard to stop taking them. I haven't taken them when I wasn't in pain more than a couple of times in the past six weeks but I am terribly afraid that when I go off them I am going to have a terrible spell of depression and generally feel awful during withdrawal. I'm also scared that they will want me to taper off the meds and I won't be able to taper - I'll take them whether I need them or not if I have them in my possession. So I'm thinking maybe the best thing to do is quit them cold turkey so I don't have the temptation to abuse them. But then we get into the "will I be able to take them properly? Probably not."
So please pray for me and send me good thoughts that I will have the strength to get off this med. (I'm taking 50-70mg a day of Percocet right now. What is amazing is that even that extremely high dose doesn't get rid of the pain at all. It just makes it tolerable).
Anyway thanks for you post.
Marsha
> Oh my goodness, i am so sorry to hear that. I hope everything is fine after the surgery.
> And yeah, it's amazing how many people in the medical field haven't even heard of or don't know what Nardil or an MAOI is. Amazing and quite aggravating too.
> But good luck to you. I wish you the best.
>
>
> > > Marsha thank heavens you posted was worried about you . Now do you have to discontinue the nardil for surgery? Love Phillipa
> >
> >
> > I have sent you a couple of mails with more details but I am doing fairly okay. I don't have to discontinue the Nardil for surgery, just can't take any anti inflammatories. I will tell them again about being on Nardil but last time I was in the hospital none of the meds they gave me had any bad interaction with the Nardil so I guess it will be the same meds this time so probably no problems. If there is a problem, I will be in the right place to deal with it - the hospital.
> >
> > The doctors and nurses hardly seem to have heard of Nardil. I have to keep telling them it's an MAOI and causes low blood pressure spells and BP fluctuations. But I think things will work out fine. I'm just so relieved to have the surgery scheduled - I can't stand this pain any longer.
> >
> > Love,
> > marsha
> >
Posted by 4WD on July 17, 2008, at 0:27:33
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Phillipa on July 16, 2008, at 19:30:15
> Marsha what can you take for fevers or a headache? Love Phillipa
Hi Phillipa,
Do you mean what can I take since I'm on Nardil? I can take anything except Demerol as far as I know. The thing that helps the most for me for headache (and fever, too, actually) is plain old aspirin. I also take anti inflammatories for pain sometimes - Mobic or Motrin or Anaprox. But for a headache aspirin works best but I have to take 3 or 4 if it's a bad headache. I hardly ever have a headache, though.
Are you having headaches and fever?
Love,
Marsha
Posted by katecmm on February 13, 2009, at 14:07:46
In reply to 6 weeks on Nardil, posted by 4WD on April 17, 2008, at 18:14:04
fantastic. The first time I went on nardil my whole wold changed. I had to go off it because i had surgery that went really badly and I was in horrible pain so they put me on Cymbalta during my 3 month stay in the hospital. I can't really do anything any more but i got off the Cymbalta and i am waiting for my beloved nardil to kick in. I went down to 2, It really wasn't as effective. So don't get your hopes up. Try Verapamil for the blood pressure and Miralax for the other stuff. Good luck. I was even able to eat blue cheese dressing. But I think from your B P you had better follow the diet to the letter.
Posted by Questionmark on February 18, 2009, at 18:42:12
In reply to Re: The lowering Nardil after remission myth (+oth » Questionmark, posted by 4WD on July 17, 2008, at 0:23:40
Sorry for lack of response. I do not often visit here anymore except for occasional obsessive/binging spurts. I hope everything has gone well though, including the difficulty with opiates. I hope all is well.
> Thank you for the good thoughts. There are really two issues I have to deal with and I'd appreciate those good thoughts and prayers. First, of course is the surgery itself. (That it go well and relieve the pain. Supposedly this procedure has about a 90% success rate and my doctor said he has done a few hundred of them so I'm not too awfully nervous about it. I'll be actually glad to get there and get it done.)
>
> Actually, the other issue worries me more. I've been on narcotic pain medication for over six weeks now and after the surgery, assuming all goes well, I'll be coming off pain meds. I am a former opiate abuser and I'll admit I have really enjoyed my pain meds. But I have built up such a tolerance to them (high tolerance to begin with because of the prior years of abuse)that it is going to be really hard to stop taking them. I haven't taken them when I wasn't in pain more than a couple of times in the past six weeks but I am terribly afraid that when I go off them I am going to have a terrible spell of depression and generally feel awful during withdrawal. I'm also scared that they will want me to taper off the meds and I won't be able to taper - I'll take them whether I need them or not if I have them in my possession. So I'm thinking maybe the best thing to do is quit them cold turkey so I don't have the temptation to abuse them. But then we get into the "will I be able to take them properly? Probably not."
>
> So please pray for me and send me good thoughts that I will have the strength to get off this med. (I'm taking 50-70mg a day of Percocet right now. What is amazing is that even that extremely high dose doesn't get rid of the pain at all. It just makes it tolerable).
>
> Anyway thanks for you post.
>
> Marsha
>
>
>
> > Oh my goodness, i am so sorry to hear that. I hope everything is fine after the surgery.
> > And yeah, it's amazing how many people in the medical field haven't even heard of or don't know what Nardil or an MAOI is. Amazing and quite aggravating too.
> > But good luck to you. I wish you the best.
> >
> >
> > > > Marsha thank heavens you posted was worried about you . Now do you have to discontinue the nardil for surgery? Love Phillipa
> > >
> > >
> > > I have sent you a couple of mails with more details but I am doing fairly okay. I don't have to discontinue the Nardil for surgery, just can't take any anti inflammatories. I will tell them again about being on Nardil but last time I was in the hospital none of the meds they gave me had any bad interaction with the Nardil so I guess it will be the same meds this time so probably no problems. If there is a problem, I will be in the right place to deal with it - the hospital.
> > >
> > > The doctors and nurses hardly seem to have heard of Nardil. I have to keep telling them it's an MAOI and causes low blood pressure spells and BP fluctuations. But I think things will work out fine. I'm just so relieved to have the surgery scheduled - I can't stand this pain any longer.
> > >
> > > Love,
> > > marsha
> > >
>
>
Posted by 4WD on February 18, 2009, at 23:05:07
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Questionmark on February 18, 2009, at 18:42:12
\thanks for your kind thoughts. I am still on Suboxone and doing okay. It doesn't work as well as it did in the beginning and they have just lowered my dose as well.
The trouble is that it treats my depression beautifully if I take enought - 6 2mg pills a day or some days I need or 8 pills a day. but they had me on 6 only. And now are lowering it to 4. When I told them that at that dose, it would not help my depression, they told me they could not legally prescribe it for depression - only for addiction and chronic pain. So I don't know what to do. Magnify my pain in the hopes that they will raise my dose back up?
Why can't they prescribe it for depression? And if they won't maybe my family doctor could? I've read that anyone with a schedule three license can prescribe buprenorphine so maybe I should go to my family doc and tell him how much it helps with depression but that they won't prescribe enough to keep the depression away.
Thinking about my options.
Thanks for thinking of me.
Marsha
Posted by Questionmark on February 19, 2009, at 0:11:41
In reply to Re: The lowering Nardil after remission myth (+oth » Questionmark, posted by 4WD on February 18, 2009, at 23:05:07
I don't think you would be able to find a family doctor/ general practitioner who would prescribe an opioid for depression. They (the DEA if not others) monitor physicians' prescribing of tightly controlled drugs, particularly opioids. And they (dr.s) can get into trouble if they are believed to be over-prescribing or carelessly prescribing these types of drugs to people (and prescribing them for depression would almost definitely be considered , well, unnecessary or careless or something). You will have more luck with a psychiatrist or psychopharmacologist but it's still highly unlikely.
I think the reason is (aside from the DEA regulations/monitoring) that opioids build up tolerance so rapidly and continuously so (and of course are highly addictive and prone to abuse). I think some would say-- and maybe rightly-- that that's irrelevant because oftentimes one does not develop tolerance to the antidepressant effects of opioids like they do with the euphoric and pain-relieving effects. I'm not sure if this is true or not. If it is, then it is very sad that opioids cannot be more easily utilized or tried.
But you would have a much greater chance of getting a buprenorphine Rx possibly if you saw the right doctor. Still may be pretty difficult though, i'm not sure. (Buprenorphine of course is not a full agonist opioid.)
Good luck still.
> \thanks for your kind thoughts. I am still on Suboxone and doing okay. It doesn't work as well as it did in the beginning and they have just lowered my dose as well.
>
> The trouble is that it treats my depression beautifully if I take enought - 6 2mg pills a day or some days I need or 8 pills a day. but they had me on 6 only. And now are lowering it to 4. When I told them that at that dose, it would not help my depression, they told me they could not legally prescribe it for depression - only for addiction and chronic pain. So I don't know what to do. Magnify my pain in the hopes that they will raise my dose back up?
>
> Why can't they prescribe it for depression? And if they won't maybe my family doctor could? I've read that anyone with a schedule three license can prescribe buprenorphine so maybe I should go to my family doc and tell him how much it helps with depression but that they won't prescribe enough to keep the depression away.
>
> Thinking about my options.
>
> Thanks for thinking of me.
>
> Marsha
Posted by 4WD on February 22, 2009, at 2:22:20
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Questionmark on February 19, 2009, at 0:11:41
I am on Suboxone now. I've been on it for about two weeks. I go to a special clinic where they are licensed to prescribe it. I broke my back last year and have chronic pain from that. That helped with getting on the Suboxone. My psychiatrist, the doctor at the pain clinic and my family doctor have all diagnosed me with endogenous endorphin deficiency. The Suboxone helps with that. At first it helped a LOT - no depression, lots of energy and motivation. But it has gradually begun to give less of that effect. It's also not as effective for pain as 100mg of Percocet a day was. But you can't have everything, right? The only problem I'm having with the Suboxone is controlling my intake. I don't crave getting high - it's impossible to get high on Suboxone anyway. I crave endorphins. And while I was managing okay on 12 mg a day, they then lowered my dose to 8mg a day and I've felt like crap ever since. Except I take an extra dose when it gets to be to much to bear - either the apathy or the pain. And then I either get in trouble for taking more than prescribed or else have to suffer for a few days on even less to make up for the extra I took the day before. I'm in that situation right now. The day ran out before the pills did and I had to take extra. This has happened two days in a row now so to keep from getting in trouble, I have to lower my dosage to even less than prescribed to make up for having taken extra the last two days. It seems like it's easier to get narcotics than it is to get Suboxone. If it's such a safe drug, with low abuse potential and little sedation and no high feeling, why is it so hard to get on it? I don't understand that part of it.
Oh, well, it's late and I'm just feeling discouraged. I always get this way when the Suboxone wears off. I'll feel better in the morning after I've had my first dose.
Marsha
> I don't think you would be able to find a family doctor/ general practitioner who would prescribe an opioid for depression. They (the DEA if not others) monitor physicians' prescribing of tightly controlled drugs, particularly opioids. And they (dr.s) can get into trouble if they are believed to be over-prescribing or carelessly prescribing these types of drugs to people (and prescribing them for depression would almost definitely be considered , well, unnecessary or careless or something). You will have more luck with a psychiatrist or psychopharmacologist but it's still highly unlikely.
> I think the reason is (aside from the DEA regulations/monitoring) that opioids build up tolerance so rapidly and continuously so (and of course are highly addictive and prone to abuse). I think some would say-- and maybe rightly-- that that's irrelevant because oftentimes one does not develop tolerance to the antidepressant effects of opioids like they do with the euphoric and pain-relieving effects. I'm not sure if this is true or not. If it is, then it is very sad that opioids cannot be more easily utilized or tried.
> But you would have a much greater chance of getting a buprenorphine Rx possibly if you saw the right doctor. Still may be pretty difficult though, i'm not sure. (Buprenorphine of course is not a full agonist opioid.)
> Good luck still.
>
>
> > \thanks for your kind thoughts. I am still on Suboxone and doing okay. It doesn't work as well as it did in the beginning and they have just lowered my dose as well.
> >
> > The trouble is that it treats my depression beautifully if I take enought - 6 2mg pills a day or some days I need or 8 pills a day. but they had me on 6 only. And now are lowering it to 4. When I told them that at that dose, it would not help my depression, they told me they could not legally prescribe it for depression - only for addiction and chronic pain. So I don't know what to do. Magnify my pain in the hopes that they will raise my dose back up?
> >
> > Why can't they prescribe it for depression? And if they won't maybe my family doctor could? I've read that anyone with a schedule three license can prescribe buprenorphine so maybe I should go to my family doc and tell him how much it helps with depression but that they won't prescribe enough to keep the depression away.
> >
> > Thinking about my options.
> >
> > Thanks for thinking of me.
> >
> > Marsha
>
>
Posted by 4WD on February 22, 2009, at 2:30:05
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Questionmark on February 19, 2009, at 0:11:41
I am on Suboxone now. I've been on it for about two weeks. I go to a special clinic where they are licensed to prescribe it. I broke my back last year and have chronic pain from that. That helped with getting on the Suboxone. My psychiatrist, the doctor at the pain clinic and my family doctor have all diagnosed me with endogenous endorphin deficiency. The Suboxone helps with that. At first it helped a LOT - no depression, lots of energy and motivation. But it has gradually begun to give less of that effect. It's also not as effective for pain as 100mg of Percocet a day was. (I was severely addicted to Percocet after breaking my back, waiting six weeks for surgery and for a month after surgery - the pain was excruciating. When the pain finally started to get better, I tried to quit the Percocet but found I couldn't. The withdrawal would send me into a state of absolute suicidal despair. The Suboxone got me through withdrawal with no depression - just the physical withdrawal symptoms.)
But you can't have everything, right? The only problem I'm having with the Suboxone is controlling my intake. I don't crave getting high - it's impossible to get high on Suboxone anyway. I crave endorphins. And while I was managing okay on 12 mg a day, they then lowered my dose to 8mg a day and I've felt like crap ever since. Except I take an extra dose when it gets to be too much to bear - either the apathy or the pain. And then I either get in trouble for taking more than prescribed or else have to suffer for a few days on even less to make up for the extra I took the day before. I'm in that situation right now. The day ran out before the pills did and I had to take extra. This has happened two days in a row now so to keep from getting in trouble, I have to lower my dosage to even less than prescribed to make up for having taken extra the last two days. It seems like it's easier to get narcotics than it is to get Suboxone. If it's such a safe drug, with low abuse potential and little sedation and no high feeling, why is it so hard to get on it? I don't understand that part of it. And it's a schedule III drug, not even a II.
Oh, well, it's late and I'm just feeling discouraged. I always get this way when the Suboxone wears off. I'll feel better in the morning after I've had my first dose.
Marsha
> I don't think you would be able to find a family doctor/ general practitioner who would prescribe an opioid for depression. They (the DEA if not others) monitor physicians' prescribing of tightly controlled drugs, particularly opioids. And they (dr.s) can get into trouble if they are believed to be over-prescribing or carelessly prescribing these types of drugs to people (and prescribing them for depression would almost definitely be considered , well, unnecessary or careless or something). You will have more luck with a psychiatrist or psychopharmacologist but it's still highly unlikely.
> I think the reason is (aside from the DEA regulations/monitoring) that opioids build up tolerance so rapidly and continuously so (and of course are highly addictive and prone to abuse). I think some would say-- and maybe rightly-- that that's irrelevant because oftentimes one does not develop tolerance to the antidepressant effects of opioids like they do with the euphoric and pain-relieving effects. I'm not sure if this is true or not. If it is, then it is very sad that opioids cannot be more easily utilized or tried.
> But you would have a much greater chance of getting a buprenorphine Rx possibly if you saw the right doctor. Still may be pretty difficult though, i'm not sure. (Buprenorphine of course is not a full agonist opioid.)
> Good luck still.
>
>
> > \thanks for your kind thoughts. I am still on Suboxone and doing okay. It doesn't work as well as it did in the beginning and they have just lowered my dose as well.
> >
> > The trouble is that it treats my depression beautifully if I take enought - 6 2mg pills a day or some days I need or 8 pills a day. but they had me on 6 only. And now are lowering it to 4. When I told them that at that dose, it would not help my depression, they told me they could not legally prescribe it for depression - only for addiction and chronic pain. So I don't know what to do. Magnify my pain in the hopes that they will raise my dose back up?
> >
> > Why can't they prescribe it for depression? And if they won't maybe my family doctor could? I've read that anyone with a schedule three license can prescribe buprenorphine so maybe I should go to my family doc and tell him how much it helps with depression but that they won't prescribe enough to keep the depression away.
> >
> > Thinking about my options.
> >
> > Thanks for thinking of me.
> >
> > Marsha
>
>
Posted by Sigismund on February 23, 2009, at 19:53:10
In reply to Re: The lowering Nardil after remission myth (+oth » Questionmark, posted by 4WD on February 18, 2009, at 23:05:07
>only for addiction and chronic pain
You *are* addicted, which you can show by declining to reduce your dose.
But maybe you would have to be treated by some special outfit?
Posted by 4WD on February 27, 2009, at 1:35:21
In reply to Re: The lowering Nardil after remission myth (+oth » 4WD, posted by Sigismund on February 23, 2009, at 19:53:10
> >only for addiction and chronic pain
>
> You *are* addicted, which you can show by declining to reduce your dose.
>
> But maybe you would have to be treated by some special outfit?Of course I'm addicted. Just like I'm addicted to Nardil and Geodon and Xanax. I'd decline reducing my dose of any of those except the Nardil which I'd love to lower. But I'm addicted to the Suboxone in a different way. It takes away my depression and gives me energy and motivation, which I haven't experienced without the use of Percocet or Lortab or some narcotic for years now. And the difference with Suboxone is that it is impossible to get high on it. I don't experience any high at all. It's designed so that you DON'T get high. It's only a partial agonist but is also an atagonist at the opiod receptors. And it had naloxone in it, which means that if I were to try taking some Percocet of something, it would do me no good. It blocks the effect of true full agonist narcotics.
So yes, I'm addicted. But I'd rather be addicted to Suboxone than to 100mg of Percocet a day, wouldn't you?
Marsha
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